Implications for the Inclusion of Echo Intensity for Athlete Monitoring: A Mini Review
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 18, Issue 3
Abstract
Ultrasound measurements have been used extensively throughout the literature as a reliable and valid method for examining muscle structure. More recently, ultrasound imaging has been used to guide the training process and it is often incorporated into ongoing athlete monitoring programs. However, most sport practitioners use ultrasound to assess muscle quantity (i.e., muscle size) yet muscle quality is often disregarded. Recent studies have begun differentiating between muscle quantity and muscle quality with the use of computerized grayscale analysis techniques using echo intensity. By using echo intensity, the sport practitioner is able to gauge both intramuscular and intermuscular cellular environments without having to use costly invasive procedures to determine markers of fatigue and training stress associated with muscle damage. Therefore, the purpose of this mini review is to highlight the efficacy of using echo intensity coupled with muscle cross-sectional area imaging to accurately assess training adaptations and recovery to, in turn, improve athletic performance.Sport practitioners (i.e., sport scientists, strength and conditioning coaches, sport coaches, and sports medicine staff) must implement appropriately planned annual training regimens, recovery strategies, and use both accepted and novel athlete monitoring protocols to continually progress athletic performance. Ultrasound measurements have been used extensively throughout the literature as a reliable and valid method for examining muscle structure and muscular adaptations as a result of resistance training [1]. Although this noninvasive method is comparable to other measurement methods such as magnetic resonance imaging [2], ultrasonography is the most practical, resourceful, and time efficient procedure for sport practitioners to implement regarding athlete monitoring. Ultrasound is most commonly used for measuring muscle quantity (i.e., muscle cross-sectional area [CSA]) [3]; however, when assessing only the size of the muscle, ultrasound instrumentation has limitations and cannot account for muscular hydration, glycogen content, triglyceride accrual, inflammation or edema (i.e., muscle swelling). More recently, echo intensity (EI) has been used to determine muscle quality (i.e., intramuscular fibrous and adipose tissue, noncontractile elements) and may give insight into the intramuscular and intermuscular cellular environments [4]. Therefore, monitoring skeletal muscle adaptations in relation to both muscle quantity and quality as a result of resistance training should be considered a mainstay for long-term athlete development [5]. Thus, the purpose of this mini review is to highlight the usefulness of incorporating EI as a sub-analysis of muscle CSA assessments for sport practitioners who currently implement ultrasound instrumentation as part of an ongoing athlete monitoring program.For the general population, ultrasound has been used most commonly to assess injuries, mortality, disease, muscle quantity and muscle quality as it relates to strength and power [6-8]. For example, previous studies have shown that muscle quality of skeletal muscle was indicative of overall strength and power in healthy elderly individuals [9]. Additionally, positive correlations have been observed between torque per unit of muscle mass and cardiovascular parameters (r=0.52 to r=0.60; P < 0.001) giving insight into the potential use to assess neuromuscular and cardiovascular performance. Echo intensity has been shown to independently contribute to muscle strength in both middle-aged and elderly persons and has shown the same contribution in the athletic population [10]. Contemporaneously, sport practitioners have used similar methods to specifically access muscle quantity to determine the effectiveness of periodization and programming as well as an athlete’s potential performance capability (i.e., talent identification) [11,12].
Authors and Affiliations
S Kyle Travis, Ai Ishida
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